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Increased Payer Outlier Reports from Special Investigations Unit

in Coding

Urgent Message from the KMC University Helpdesk | June 28, 2021

Have you received Your letter yet? Five thousand doctors in Illinois have received a letter from the Special Investigations Unit regarding outlier coding and billing. BCBS of IL sent a notification to offices as part of their commitment to improving members' access to quality and affordable health care. In the report, they state, "your practice was identified as an outlier (above on standard deviation from the mean) for claims submitted to BCBSIL... In short, the medical necessity for manipulation of the region must be evidenced in your documentation, and claims where medical necessity is not supported by required documentation are not reimbursable."

How do you measure up? As our commitment to helping your office, we are offering a $29 discount for our Proactive Chart Review. You must mention the code Outlier29 to receive your discount. You will submit one new patient from the past 90 -180 days to KMC University for a certified specialist to review. Once we have reviewed the documentation, one of our doctors will meet with you to review their findings. Let us find the vulnerabilities and deficits before there is a knock at your door.

Get started now, $29 savings ends Friday, July 2, 2021.


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